TY - CHAP M1 - Book, Section TI - Follicular Lymphoma A1 - Strati, Paolo A1 - Gunther, Jillian R A1 - Medeiros, L. Jeffrey A1 - Nastoupil, Loretta J. A2 - Kantarjian, Hagop M. A2 - Wolff, Robert A. A2 - Rieber, Alyssa G. Y1 - 2022 N1 - T2 - The MD Anderson Manual of Medical Oncology, 4e AB - KEY CONCEPTSPatients with early-stage follicular lymphoma (FL) can experience prolonged remissions with radiation therapy, particularly in the presence of stage I disease and lesions smaller than 3 cm; as such, surveillance should be reserved only to patients who are not candidates for radiation.High tumor burden in patients with FL is defined by the presence of one or more Groupe d'Etude des Lymphomes Folliculaires (GELF) criteria; these include: significant lymphadenopathies (one >7 cm or three each >3 cm), splenomegaly, impending organ compromise, pleural effusion, elevated circulating lymphoma cells, and cytopenia. Among patients with advanced-stage FL, those with high tumor burden should be considered for active treatment; in the presence of low tumor burden, observation or single-agent rituximab are potential management strategies.Both chemoimmunotherapy and immunotherapy (with lenalidomide) are potential treatment options for patients with advanced-stage, high tumor burden FL; pretreatment positron emission tomography–computed tomography (PET-CT) scan may identify patients who would benefit from an anthracycline-based regimen.PET-CT scan performed at the end of chemoimmunotherapy is considered prognostic. Response to frontline therapy may inform pursuit of maintenance therapy given retrospective data suggesting the largest impact of maintenance rituximab observed among those achieving a partial response to frontline chemoimmunotherapy.Patients with FL who progress within 24 months from the initiation of frontline chemoimmunotherapy may have a shorter overall survival; these patients should be evaluated for clinical trials with novel agents or cellular therapy SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1190832581 ER -